Provider Demographics
NPI:1982406385
Name:MCCLAIN, TAUSHA CHARAE (APRN)
Entity type:Individual
Prefix:
First Name:TAUSHA
Middle Name:CHARAE
Last Name:MCCLAIN
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9053 BIGHORN TRL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-1673
Mailing Address - Country:US
Mailing Address - Phone:904-609-1357
Mailing Address - Fax:
Practice Address - Street 1:9053 BIGHORN TRL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32222-1673
Practice Address - Country:US
Practice Address - Phone:904-609-1357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAG03250072363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology